Hi - I think more assessment could be helpful.  Sometimes a baby holds his tongue high with an open mouth to protect the airway.  You see this frequently when a baby is crying.  A baby may have developed a habit of sucking on his tongue and pressing it against his palate in utero.  This could result in a groove in the palate which could cause some injury to the nipple if it gets placed into the groove or if baby presses nipple with tongue.  

Often a baby with a tongue tie cannot touch the roof of his mouth with his tongue when the mouth is open as you describe, since tongue restriction can impact all directions of movement - not just extension.

Has a suck assessment been done?

I don't have the energy to climb up to my third floor to check, but I'm going to bet that Catherine Genna Watson's "Supporting Sucking Skills" will have some helpful info.  Tongue ties and unusual palates as well as assessing a palate with a finger are discussed on page 637 of Mohrbacher's "Breastfeeding Answers Made Simple" - a book I happen to have with me on the 1st floor right now!

Ellen

Ellen Rubin, MA, IBCLC, LLLL

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